Provider Demographics
NPI:1336542018
Name:ANASTAS, CATHERINE (LCSW)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:ANASTAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-1369
Mailing Address - Country:US
Mailing Address - Phone:269-408-8474
Mailing Address - Fax:269-408-8725
Practice Address - Street 1:521 STATE ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-1369
Practice Address - Country:US
Practice Address - Phone:269-408-8474
Practice Address - Fax:269-408-8725
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010974461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical